Les urgences pédopsychiatriques aux cliniques universitaires Saint-Luc à Bruxelles : état des lieux et pertinence de la création de lits de crise

Abstract

BackgroundIn Western societies, the amount of consultations in emergency wards has largely increased. This phenomenon also affects child and teenager psychiatry as the number of emergencies and crisis states has experienced a sharp growth. This phenomenon is highly linked to mentality evolutions and changes in Western society, all requiring a prompt response to suffering, especially when considering that of the child. In addition, this phenomenon also needs to be understood considering that the situation of children in families and societies has known several changes these past decades in parallel to the consideration given to children's mental suffering, MethodsThrough this article, we conducted an “inventory” of child and teenager psychiatric emergency situations and crisis states at Saint-Luc University Clinic in Brussels, collecting epidemiological data from the emergency department regarding the past three years: 2011, 2012 and 2013 (number of juvenile minors admitted, age, percentage of minors compared to the total adult psychiatric population). Some of the data were compared with those collected in an article we published in 2009. ResultsWe can observe an increase in number of children admitted to the crisis unit and psychiatric emergency department these last three years, with significant inflation of the 14–17 (full elapsed) years old group. In comparison with the data collected in 2009, we observed that the percentage of juveniles under 14 and under 12years old admitted, in proportion to the overall population of minors is increasing, indicating a decrease in the age of youth admitted. Conclusions and perspectivesThese considerations lead us to revise our device of care, through an afterthought on the relevance of creating “crisis inpatient beds” to hospitalize some children and teenagers admitted for psychiatric emergencies or crisis states. Indeed, the question of hospitalization is regularly raised implicitly or explicitly when admitting a child or teenager with his family in the emergency psychiatric unit. Considering the current structures already provided by our clinic, the question of framework, risks, and the different issues around the creation of this new device of care, such as “crisis beds” will be assessed in the light of our clinical experience and supported by elements of reflexion gathered from the literature.